照顧一位表現出「黃昏症候群」的失智症病人時，下列哪些介入是必要的？（選所有適合的）
Which of the following interventions are essential when caring for a client with dementia who exhibits 'sun-downing' syndrome? (Select all that apply.)
- AIncrease physical activity during the daylight hours✓ 正解在白天增加身體活動
- BMinimize noise and environmental stimuli in the evening✓ 正解在傍晚時分減少噪音與環境刺激
- CKeep the room brightly lit during the night to prevent confusion夜間保持房間明亮以預防混淆
- DMaintain a consistent daily routine✓ 正解維持一致的日常作息
- ELimit fluid intake after 2:00 PM to prevent nocturnal awakening下午 2 點後限制液體攝取以預防夜間醒來
黃昏症候群（Sun-downing syndrome）常見於失智症病人，特徵為傍晚時分出現混亂、焦慮、激動或行為異常。其核心機制與生理時鐘（Circadian rhythm）紊亂及環境刺激過載有關。護理介入重點在於調整環境與作息，以維持病人的定向感並減少傍晚的壓力負荷。A、B、D選項均符合此原則，透過日間活動刺激、傍晚降低刺激及規律作息來減輕症狀。
Managing sundowning involves maintaining a consistent daily routine, increasing daytime physical activity to regulate the sleep-wake cycle, and minimizing environmental stimuli in the evening. These interventions help reduce agitation and confusion associated with circadian rhythm disruptions.
美國臨床對於失智症照護強調「Person-Centered Care」（以人為中心的照護），非常重視非藥物介入（Non-pharmacological interventions），盡量避免使用抗精神病藥物來控制黃昏症候群，這與台灣臨床有時傾向使用藥物控制病人的作法有顯著差異。